Pulmonary Embolism Interventional Treatment Methods

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 13, 2024
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Interventional treatment for pulmonary embolism is mainly used for large pulmonary embolisms in the main trunk or major branches of the pulmonary artery. It is applicable in the following scenarios: contraindications to thrombolysis and anticoagulation therapy, inefficacy after thrombolysis or aggressive medical treatment, or lack of surgical conditions. Interventional therapy for pulmonary embolism can involve removing the embolus or breaking it into fragments, allowing it to move to the distal pulmonary arteries, thereby opening the central pulmonary arteries, rapidly reducing pulmonary artery resistance, significantly increasing total pulmonary blood flow, improving cardiopulmonary hemodynamics, and right ventricular function. The treatment involves catheter fragmentation and suction of large clots in the pulmonary artery or performing balloon angioplasty, and it also enables local administration of small-dose thrombolysis. These are the primary methods of interventional treatment for pulmonary embolism.

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Written by Wang Li Bing
Intensive Care Medicine Department
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Pulmonary embolism should be treated in the department of respiratory medicine.

Pulmonary embolism is an emergency in clinical settings, with rapid progression and extreme danger, and is generally treated by the department of respiratory medicine. Pulmonary embolism primarily occurs due to dislodged blood clots that block the pulmonary artery and its branches, leading to pulmonary infarction. The clinical manifestations of pulmonary embolism mainly include severe breathing difficulties, chest pain, coughing up blood, and even circulatory disturbances. After a pulmonary embolism occurs, a pulmonary artery CT scan can be used to further confirm the diagnosis. Treatment options may include thrombolysis, and possibly anticoagulation therapy with low molecular weight heparin or warfarin. (Specific medications should be used under the guidance of a physician.)

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Written by Chen Tian Hua
Cardiology
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What are the early symptoms of pulmonary embolism?

The early symptoms of pulmonary embolism are clinically diverse and often non-specific. Mild cases may not present any symptoms at all. Common symptoms include the following: 1. Unexplained difficulty in breathing; 2. Pain in the precordial region; 3. Some patients initially present with fainting as the first clinical symptom; 4. Some patients may also experience irritability, fear, or a near-death feeling; 5. Early symptoms can also include coughing, coughing up blood, and palpitations. Pulmonary embolism is a critical condition in clinical settings. Once it occurs, it is essential to go to the hospital promptly for an accurate diagnosis and to receive effective treatment to avoid severe clinical consequences.

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Written by Yuan Qing
Pulmonology
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Why should one lie flat for acute pulmonary embolism?

When acute pulmonary embolism occurs, it is primarily due to a thrombus from the venous system being carried by the venous blood flow back to the right heart, and then due to the ejection from the right heart, this thrombus gets lodged in the pulmonary artery, forming a pulmonary embolism. After the onset of pulmonary embolism, the primary treatment measure is to have the patient lie down and remain still. The reason is mainly that if the patient is standing or moving, it is very likely that the thrombus in the venous system could continue to detach and move within the venous system. This can worsen the symptoms of pulmonary embolism or lead to new embolic sites, so the treatment for the patient involves immobilization and lying down to avoid further movement, making this the most basic approach to treatment.

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Written by Yuan Qing
Pulmonology
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The difference between pulmonary embolism and pulmonary congestion

Pulmonary embolism and pulmonary congestion are two completely different diseases. Pulmonary embolism is mainly caused by the thrombosis of the venous vessels entering the pulmonary artery, thereby causing restricted blood flow in the pulmonary artery and leading to pulmonary embolism. Pulmonary congestion is often due to left heart failure, where the blood flow in the lungs cannot return to the left heart, causing the blood to be retained and congested in the lungs, forming this disease. However, they do have some similarities, such as presenting symptoms of difficulty breathing, shortness of breath, low blood pressure, shock, etc. But through diagnosis and additional examinations, these two diseases can be clearly differentiated. Therefore, careful differentiation is required in clinical practice because the treatments for the two diseases are completely different. If misdiagnosed, the treatment could be incorrect, leading to serious consequences from mistreatment.

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Written by Li Qiang
Intensive Care Unit
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Why does pulmonary embolism cause cardiac arrest?

The mechanisms causing cardiac arrest due to acute pulmonary embolism mainly encompass several aspects. One is a large-scale acute extensive pulmonary embolism, which prevents the blood from being ejected from the right heart, potentially leading to acute right heart failure. At this time, the entire body's blood circulation will encounter issues. Another scenario is that following the pulmonary embolism, it causes severe hypoxia. This hypoxia can lead to oxygen deficiency in all organs of the body, including the heart. The coronary arteries that supply nutrients to the heart can also become ischemic. Both of these factors can cause the heartbeat to lead to sudden cardiac arrest. These are the primary mechanisms that can cause a sudden stop in the heartbeat.